The ability of the Contact Lens Dry Eye Questionnaire (CLDEQ)-8 to detect ocular surface alterations in contact lens wearers

• Published in: Contact lens & anterior eye Vol. 42; no. 3; pp. 273 - 277
• Main Authors: López-de la Rosa, Alberto, Arroyo-del Arroyo, Cristina, Enríquez-de-Salamanca, Amalia, Pinto-Fraga, José, López-Miguel, Alberto, González-García, María J.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.06.2019
• Subjects: Adult; CLDEQ; Clinical sign; Conjunctival Diseases - diagnosis; Conjunctival Diseases - etiology; Contact lens; Contact Lenses, Hydrophilic - adverse effects; Corneal Diseases - diagnosis; Corneal Diseases - etiology; Discomfort; Dry Eye Syndromes - diagnosis; Dry Eye Syndromes - etiology; Female; Humans; Male; Osmolar Concentration; Osmolarity; Slit Lamp Microscopy; Surveys and Questionnaires; Tears - chemistry; Tears - physiology; Young Adult; Discomfort; Clinical sign; Osmolarity; CLDEQ; Contact lens
• ISSN: 1367-0484; 1476-5411
• DOI: 10.1016/j.clae.2018.11.012

•Soft contact lens wear is associated with an increase in tear osmolarity and limbal hyperaemia.•Tarsal conjunctiva may have a role in the development of contact lens discomfort.•The use of questionnaires alone remains being the best approach to detect contact lens discomfort. To study whether some ocular surface alterations could be associated with contact lens (CL) wearers suffering from CL discomfort (CLD) detected using the Contact Lens Dry Eye Questionnaire (CLDEQ)-8. Forty-one soft CL wearers further classified into symptomatic CL wearers (SCLW) and asymptomatic CL wearers (ACLW) by the CLDEQ-8, and 20 non CL wearers (NCLW) were included. Tear osmolarity, slit-lamp biomicroscopy findings, tear film break-up time, corneal and conjunctival staining, and Schirmer test were performed 24 h after CL removal. Data were compared among groups using the analysis of variance and the Student t-test or the Kruskal-Wallis H and the Mann-Whitney U tests, applying the Bonferroni correction. Correlations between the CLDEQ-8 and the clinical signs were performed using the Spearman correlation coefficient. Twenty-four SCLW, 17 ACLW and 20 NCLW were recruited. There were significant differences among groups for tear osmolarity (p < 0.001), limbal hyperaemia (p = 0.014), and tarsal hyperaemia (p = 0.031). Pairwise comparisons revealed that SCLW and ACLW had higher tear osmolarity (p < 0.003, both comparisons) and limbal hyperaemia (p = 0.027 and p = 0.048, respectively) than NCLW. Moreover, SCLW had higher tarsal hyperaemia (p = 0.030) than NCLW. No significant correlations were found (p > 0.05). The CLDEQ-8 was ineffective to detect clinical alterations between SCLW and ACLW; therefore, the use of questionnaires alone remains being the best approach to detect CLD. The role of the tarsal conjunctiva in the development of CLD should be analyzed in future studies.